On the afternoon of Tuesday 11 January, Robert Winston and I met at the Lords. The interview had been planned before Christmas but postponed because Lord Winston’s mother was ill. By chance, our meeting took place in the febrile climate of an NHS crisis. I had thought that Winston might have some uncompromising views on the genetic revolution and its likely impact on the health service. Only recently Dr Ron Zimmern, a main government adviser on genetics, reportedly predicted that gene science would impinge “with devastating significance on clinical practice”.
Winston wished to discuss a less abstract form of clinical devastation. His focus, on the desperate state of healthcare, ran contrary to government insistence that it was effecting a Lazarus-style resurrection of the NHS. (Those, it should be stressed, were not his precise words. As both normal interviewing standards and subsequent events decreed, precision was of the essence here.)
Over an hour and a quarter, Lord Winston rarely deviated from his central theme. Prompted partly by the plight of his elderly mother, still ill after a dreadful hospital sojourn, he offered an uncompromising attack on the health service under Labour. The government had been “deceitful” over its abrogation of the promise to wipe out the internal market. Tony Blair had been kept in the dark by “a conspiracy of silence”, medical care was “deeply unsatisfactory for a lot of people”, and so on.
The interview was published three days later, in last week’s NS. I had expected a strong reaction. So, I presume, had Winston, who told me: “I shouldn’t really be saying these things to you.” Of all his remarks, this was the one with which Downing Street spin-doctors wholeheartedly concurred.
The first wave of reaction was predictable. The article was widely covered in all papers and reproduced in the Daily Mail. By breakfast time on Friday, Alan Milburn, the Health Secretary, was on the Today programme, deeming Winston “fanciful”. Later that morning, Winston issued a statement through the Press Association after a “conversation” with the Prime Minister’s spokesman, Alastair Campbell.
I am not privy to the content of that talk, but it sounded mind-bending. Afterwards, Winston could not recall using the word “deceit”. He thought new Labour was on the right lines on health policy, and he was “adamant” that he had made no comment on Cherie Blair’s pregnancy.
“Oh, that is where Cherie Blair is having her Caesarian section,” he had told me after we talked about the Chelsea and Westminster Hospital. Both my editor and I thought it fair to include that aside.
Neither of us imagined that it would become a spin-doctor’s lash for Winston, who had dropped his hand towards the tape-recorder, in the manner of someone confiding a fragment of gossip. “Why don’t we change the subject?” he added.
He did not ask for the remark to be expunged from the interview; although he did request that other, unrelated, comments were taken off the record. They remain so.
The suggestion that a 45 year old whose last child was delivered by Caesarian should opt for a similar procedure at a previously named hospital was hardly seismic. If an eminent doctor had revealed that Cherie Blair planned to give birth in a yurt on Dartmoor, that would have been a story. Still, the Blair fragment turned out to be the spark that ignited a supposed health service revolution.
Winston emerged from his home on Friday morning, looking beaten and dejected after his No 10 debriefing. His throwaway remark on Mrs Blair had, it seemed, become not only a lever to manoeuvre him into muting his views on health, but a multiple damage-mending tool. If the comment – offered, as stated in the article, through a partly covered microphone – could not be produced, then the whole interview might appear tainted. If it were verified, then Winston’s attack might seem discredited.
Shortly before 1pm on Friday, that section of the tape was played down my kitchen phone line to the BBC. Winston’s remark – inaudible on radio until the words were later amplified by BBC sound engineers – was duly verified on The World At One. And so the story took off; a saga of spin-doctors’ bungled attempts to gag Winston. At issue now was new Labour’s suppression of the dire state of the NHS.
Normally, I would keep quiet. Interviews, beyond the published material, are private. Here, an addendum seems justifiable. Winston has had the plaudits for his courage in speaking out, but spin-doctors, too, should get their praise for so neatly illustrating his central theme. Better, it seemed, a campaign of obfuscation than an acknowledgment of the truth. Shoot the messenger rather than face the message.
As it turned out, consultants, patients and Winston’s sister backed his original words. Tony Blair appeared on Breakfast with Frost to proffer balm and billions. By 2006, he pledged, UK health spending would be lifted to the average for the European Union. Winston was adjudged a prime architect of NHS salvation.
And so he may prove to be. But his point was that the whole basis of health service funding must be revisited, either through raising taxes or a social insurance system designed on the continental model. There is now some pressure for a hypothecated tax. There is the Chancellor’s war chest to plunder. There is a recognition that tax rises are no longer the last taboo. Perhaps best of all is the final demolition of the myth that we can have a world-beating health service on the cheap.
Still, no solution this side of radical funding and structural revision will ultimately solve the problems Winston sketched: a system in which good primary care is the shining facade to empty operating theatres; a system in which consultants are frustrated, nurses overworked and patients too frequently left to languish or die.
Regrettably, it seems unlikely that “Tony’s favourite doctor” will be invited to No 10 to elaborate on his themes.
A signal flaw of this government is its recoil from any deviation to the decreed script. Sir David Ramsbotham, the chief inspector of prisons, calls (also in the NS) for the early release of James Bulger’s killers and is publicly carpeted by the Home Secretary. Robert Winston offers his analysis of the health service and finds himself propelled into quicksands.
Why, all interviewers must sometimes wonder, should people like them ever speak to people like us? Only for this. Ramsbotham’s remarks, made in the careful context of his analysis of the prisons service, served to open the debate he sought on the shortcomings of the penal system and society’s duties on rehabilitation. Winston’s comments have been heralded as the propellant for a more effective and more honest health strategy.
Perhaps he wishes he had never opened his mouth. Perhaps he regrets being hustled into an unsustainable retraction. I don’t know. I hope only that, once the dust has settled, he thinks that it was worth the shout. If at least some NHS improvements clamoured for by the nation kick in, then Winston can take much credit.
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